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HomeMy WebLinkAbout235414 JUDGE NETTING INC - INSURANCE CERTIFICATE (8)CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/26/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Robert Harris Insurance Agency, Inc. Lic. #0216736 3150 Bristol St., Suite 200 Costa Mesa CA 92626 CONTACT NAME: Adriana Lopez FAX A/CO No Ext: (714) 619-4480 A/C No: (714)619-4481 E-MAIL ADDRESS:adriana@reharris.com INSURER(S) AFFORDING COVERAGE NAIC# INSURERA:West American Insurance Company 44393 INSURED Judge Netting, Inc. 427 E. 17th St. Costa Mesa, CA 92627 INSURERB:American Fire & Casualty Company 24066 INSURERC:BHHC INSURERD:Continental Divine Insurance INSURERE: INSURER F : CnX1FRAnP_q cFRTIFICATF NIIMRFP-18/19 REVISION NUIMRER! THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR OF INSURANCE ADDLITYPE INgQ SUER POLICY NUMBER MM/DD/YPOLICY EYYY MML DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE � OCCUR A AGE PREM SESOEa oNcurIT1rence $ 100 , 000 MED EXP (Any one person) $ 15, 000 X BKW58275737 1/1/2018 1/1/2019 PERSONAL & ADV INJURY $ 1, 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 , 000 , 000 PIPOLICY a JPECo� LOC PRODUCTS - COMP/OPAGG $ 2,000,000 Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO AOSCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS X BAA58275737 1/1/2018 1/1/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ Medical Expense $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5 , OOO , 000 B EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ ESA58275737 1/1/2018 1/1/2019 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N ANY PROPRIETOR/PARTNER/EXECUTIVE nWC908357 1/1/2018 1/1/2019 X PEROTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 D OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A JUWC908497 1/1/2018 1/1/2019 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Netting for City Park and Collindale Golf Course. The City is named as Additional Insureds as their interest(s) may appear regarding any and all work performed by the above named insured with respects to General Liability and Auto Liability per the attached CG8810 04/13 and GECA701 0107. CERTIFICATE HOLDER C:ANLtLLAI IVN The,City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE M Lauren Atkinson/ALO -- - © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)